<?php echo form_tag($url,array('id'=>'formActionVerifier',));?>
  <?php $parameters->rewind()?>
  <?php while($parameters->valid()):?>
    <input type="hidden" name="<?php echo $parameters->key()?>" value="<?php echo $parameters->current()?>"/>
    <?php $parameters->next()?>
  <?php endwhile;?>
  <?php echo urldecode(htmlspecialchars_decode($prompt,ENT_QUOTES))?>
  <table class="form">
    <tr>
      <th>Confirmation Number:</th>
      <td><input type="text" name="confirm" value="<?php echo rand(10000,99999)?>" readonly="true" id="inputActionVerifierConfirm"/></td>
    </tr>
    <tr>
      <th>Verify Number:</th>
      <td><input type="text" name="verify" id="inputActionVerifierVerify"/></td>
    </tr>
    <tr>
      <td>
      </td>
      <td style="text-align:center;">
        <input type="submit" value="Verify"/> | 
        <input type="button" value="Cancel" id="buttonCancelActionVerify"/> 
      </td>
    </tr>
  </table>
</form>
<script language="javascript">
  $(document).ready(
    function(){
      actionVerifierSetupForm(<?php echo $callback ?>);
      $('#buttonCancelActionVerify').click(
        function(){
          <?php echo urldecode(htmlspecialchars_decode($cancel_callback,ENT_QUOTES)) ?>
        }
      );
    }
  );
</script>